Urinary incontinence (UI) and lower urinary tract symptoms (LUTS) affect almost half of US women and cause substantial distress, diminished quality of life, and dramatic limitations in daily functioning. Obesity, a US and worldwide epidemic associated with enormous health and quality of life impact, is one of the strongest independent risk factors for UI and weight loss is an effective treatment for UI. However, the mechanisms by which obesity promotes UI and LUTS and why weight loss is an effective or UI in women are poorly understood. This proposal outlines a 5-year K24 Midcareer Investigator Award in Patient-Oriented Research (POR) renewal application for the candidate to expand her mentoring work with early career patient oriented researchers and promote a multidisciplinary, translational research paradigm focused on the association of weight and weight loss with UI and LUTS. In addition to mentoring plans, the proposal outlines specific aims to continue to advance our understanding of the association of UI, LUTS, and obesity in women by examining the effect of weight and weight loss on UI/LUTS in women, the possible roles of inflammation, physical activity, stress, and body habitus in the relationship between obesity and UI/LUTS, and facilitate the translational development of novel approaches to treatment and prevention of these conditions. The goals of this patient-oriented research and mentoring proposal will be achieved by efficiently leveraging existing resources, including ongoing NIH-funded clinical trials, comprehensive datasets, and productive research collaborations. The candidate's long-term goals are to be a leader in UI research, to contribute substantially to our understanding and approaches to the treatment and prevention of UI and LUTS, and to mentor the next generation of investigators interested in the epidemiology and treatment of female incontinence. Elucidating the mechanisms of the association between obesity with UI and LUTS in women will facilitate the translational development of novel approaches to treatment and prevention of these conditions. Strengths of the candidate include her formal training in research methods, history of research productivity and NIH funding, and a successful track record of mentoring junior trainees. Strengths of the institution include the resources of the UCSF CTSI and K30 Clinical Research Curriculum Award, several K12 training grants from which to recruit mentees, a unique formal mentor training program, and the availability of resources to foster research of junior POR investigators. The candidate has the enthusiastic support of her department, the UCSF CTSI, and patient-oriented research collaborators to pursue her research goals. The protected time provided by the K24 program is critical for the candidate to continue mentoring the next generation of investigators committed to patient-oriented research in the female lower urinary tract and advancing innovative research on the obesity-UI/LUTS associations.